ArticleEClinicalMedicine2026
Real-world effectiveness of antiretroviral backbone regimens on viral suppression in pediatric and adolescent HIV care: a six-year cohort study from Uganda.
Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Optimizing nucleoside reverse transcriptase inhibitor (NRTI) backbones is vital for pediatric and adolescent HIV treatment, yet real-world comparative evidence is limited. This study assessed backbone regimen effectiveness and factors influencing viral suppression (VLS) in Uganda. Methods: We conducted a retrospective cohort of 1033 children and adolescents (≤19 years) receiving HIV care in Uganda (2018-2023). Participants received Tenofovir Disoproxil Fumarate (TDF, 57.3%), Abacavir (ABC, 32.7%), or zidovudine (AZT, 10.0%). Viral load (VL) suppression was classified as suppressed (≤200 copies/mL), low-level viremia (201-999 copies/mL), and high-level viremia (≥1000 copies/mL). Outcomes were compared by χ Findings: Overall VLS was 83.5%. VLS was highest among TDF recipients (84.8%), followed by ABC (82.8%), and lowest with AZT (78.6%; p = 0.313). AZT recipients had the highest high-level viremia (19.4%) and greater odds of non-suppression compared with ABC (adjusted odds ratio [aOR] 2.02, 95% CI 1.20-3.40; p = 0.008). TDF was associated with lower odds of non-suppression in bivariable analysis (OR 0.71, 95% CI 0.53-0.95; p = 0.023 but was not significant after adjustment (p = 0.748). Increasing age reduced the odds of non-suppression by 8% per year (aOR 0.92, 95% CI 0.86-0.98; p = 0.006), while male sex increased odds of non-suppression (aOR 1.36, 95% CI 1.03-1.81; p = 0.033). Later VL testing time points were linked to improved suppression (aOR 0.95, 95% CI 0.91-1.00; p = 0.037). Interpretation: Overall VLS exceeded 80% but fell short of the UNAIDS 95% target. TDF-backbones had the highest success, AZT the lowest. Younger age and male sex predicted poorer outcomes. These results highlight the need for optimized regimens, targeted adherence support, and strengthened programs to improve pediatric and adolescent HIV care. Funding: National Institute for Health and Care Research (NIHR), United Kingdom through the Royal Society for Tropical Medicine and Hygiene Early Career Grants.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.